Bariatric Surgery: How complex is this? Pradeep Pallati, MD, FACS, FASMBS
|
|
- Marjorie Newton
- 6 years ago
- Views:
Transcription
1 Bariatric Surgery: How complex is this? Pradeep Pallati, MD, FACS, FASMBS
2 Nothing to Disclose
3 Types of Bariatric Surgery Restrictive Malabsorptive Combination Restrictive and Malabsorptive Newer Endoluminal Procedures
4 Types of Bariatric Surgery Restrictive Vertical Banded Gastroplasty Adjustable Gastric Banding Sleeve Gastrectomy
5 Restrictive Procedures Vertical Banded Gastroplasty A small gastric pouch is created using both staples and band staples are used to partition the vertical portion of the stomach and a band is used in the lower portion to create a narrow opening and give the restriction. The band is not adjustable
6 Restrictive Procedures Vertical Banded Gastroplasty Staple line disruption 27-48% stomal stenosis 20-33% band erosion 1-7% GERD, weight regain and longterm inadequate weight loss
7 Restrictive Procedures Adjustable Gastric Banding The adjustable gastric band is a silicone belt with an inflatable balloon in the lining that is buckled into a closed ring around the upper stomach. A reservoir port is placed under the skin for adjustments to the stoma size.
8 Restrictive Procedures Sleeve Gastrectomy It involves resection of the major part of the fundus and body of the stomach starting around 6cm proximally from the pylorus
9 Malabsorptive Procedure Jejunoileal Bypass The proximal jejunum is divided 14 inches from Ligament of Treitz and anastomosed to terminal ileum 4 inches proximal to ileocecal valve Severe electrolyte, nutrient and vitamin deficiencies Protein-Energy Malnutrition with alopecia and liver failure Renal oxalate urolithiasis Polyarthropathy
10 Types of Bariatric Surgery Combination Restrictive and Malabsorptive Roux-en-Y Gastric Bypass Mini Gastric Bypass Bilio-Pancreatic Diversion with Duodenal Switch (BPD-DS)
11 Combination Procedures Roux-en-Y Gastric Bypass A small proximal pouch is created out of the larger stomach Gastric pouch is bypassed into a Roux limb Jejuno-jejunostomy distally provides for diversion of food from digestive juices for around 1/3 bowel
12 Combination Procedures Mini-Gastric Bypass Much larger stomach pouch is created similar to sleeve gastrectomy Instead of Roux-en-y configuration, loop gastro-jejunostomy is created around cm length.
13 Combination Procedures BPD-DS standard sleeve Duodenum is divided distal to the pylorus & anastomosed to ileum 250cm proximal to ileocecal valve The bilio-pancreatic limb is anastomosed to ileum 100cm from the ileocecal valve The common channel is only 100cm resulting in significant malabsorption
14 Endo-luminal Procedures Intragastric Balloon (Orbera, Apollo surgery; ReShape Duo, ReShape Medical Inc. & Obalon Balloon system, Obalon Therapeutics, Inc. ) FDA approved for Obese patients with BMI Kg/m2 Typically filled with mL of fluid Even unto 900mL in the dual balloons Should be removed 6 months later 20-40% Excess weight loss (6.6% - 10% of body weight compared to 3.3% with placebo)
15 Bariatric Surgery in % 42% 8% 2%
16 Bariatric Surgery: Short and Long term Complications Pradeep Pallati, MD, FACS, FASMBS
17 Short-term Complications Serious complications leak Stricture Hemorrhage portal venous thrombosis
18 Short-term Complications Leak Mostly at the angle of His after sleeve gastrectomy Usually there is an associated stricture distally Managed conservatively with adequate drainage, endoscopic stents and nutrition
19 Short-term Complications Stricture Near the incisor in sleeve gastrectomy At the gastrojejunal anastomosis in bypass Managed conservatively with endoscopic dilation and in difficult cases, with stenting
20 Short-term Complications Hemorrhage Along the staple lines in both sleeve and gastric bypass Decreased with staple line reinforcement and intraoperative fibrin sealant Managed with transfusion and rarely surgical evacuation
21 Short-term Complications Venous thromboembolism DVT (0.22%), PE (0.2%) & Portal vein thrombosis (0.04%) PVT usually presents as abdominal pain 1-4 weeks after sleeve gastrectomy Can potentially result in intestinal gangrene Only known risk factor is h/o prior DVT From Michigan Bariatric Surgery Collaborative
22 Short-term Complications Medical complications UTI 0.67% Pneumonia or intubation >48 hrs 0.55% Cardiac events 0.05% Renal failure 0.08% C diff infection 0.16%
23 Sleeve Gastrectomy Complications Outcome % of patients (95% CI) Any complication 5.4 ( ) Potentially life-threatening 1.5 ( ) Staple line Leak 0.46 ( ) Stricture 0.28 ( ) Small bowel obstruction 0.06 ( ) Ulcer 0.05 ( ) Hemorrhage (requiring transfusion) 1.6 ( ) Abdominal abscess 0.36 ( ) Medical complications Urinary tract infection 0.67 ( ) Respiratory (pneumonia or intubation >48 hours) 0.55 ( ) Venous thromboembolism 0.28 ( ) Cardiac event 0.05 ( ) Renal failure 0.08 ( ) Clostridium difficile infection 0.16 ( ) Pradarelli, Jason C. et al. Hospital Variation in Perioperative Complications for Laparoscopic Sleeve Gastrectomy in Michigan. Surgery (2016): PMC. Web. 2 Sept
24
25 Composite Complication Rate (%) of 8 procedures in patients with Diabetes Mellitus Aminian, A., Brethauer, S. A., Kirwan, J. P., Kashyap, S. R., Burguera, B. and Schauer, P. R. (2015), How safe is metabolic/diabetes surgery?. Diabetes Obes Metab, 17: doi: /dom.12405
26 Comparative Mortality Trends 0.58% 0.38% 0.27% 0.20% 0.15% 0.06% 0.01% Nguyen et al, SOARD 2012
27 Mortality Trends Nguyen et al, SOARD 2012
28 Long term Complications Ventral hernia Intestinal obstruction Adhesions Internal hernia % Anastomotic stricture 5-27% Marginal Ulcer 1-16% Gallstones 2-20%
29 Long term Complications Nutrient deficiencies Alcohol Use Disorder 7.6% 9.6% Dumping syndrome Early (hypovolemic) - sweating, palpitations, drowsiness, and the need to lie down ~ 19% Late (hypoglycemia) - sweating, drowsiness, trembling, or even coma ~ 12% Nephrolithiasis Increased risk with gastric bypass - RR of1.73 (95% CI, ) Decreased risk with sleeve and Banding - RR of 0.37 (95% CI, ) Depression - increased risk in patients with underlying depression prior bariatric surgery
30 Bariatric Surgery: When is the best time for the surgery Pradeep Pallati, MD, FACS, FASMBS
31 Impact of Gastric Bypass Operation on Survival: A Population-Based Analysis Flum DR and Dellinger EP Journal of the Am College of Surgeons 2004;199: year Mortality No Surgery Surgery All ages 16.3% 11.8% Under % 3%
32 45 year-old female with diabetes and a BMI of 45 kg/m2, and no h/o HTN, CAD or CHF, would gain 6.7 additional years of life expectancy with bariatric surgery (38.4 yrs vs yrs) 45 year-old female with a BMI of 45 kg/m2 and HTN, CAD or CHF would be expected to have much shorter life expectancy but would still gain 6.7 additional years of life expectancy (22.3 yrs vs yrs) A 45 year-old male with diabetes and a BMI of 45 kg/m2, and no h/o HTN, CAD or CHF, also gained an additional 6.5 years of life expectancy with bariatric surgery (33.7 yrs vs yrs) A 45 year-old male with a BMI of 45 kg/m2 and HTN, CAD or CHF would gain 5.4 years of life expectancy (17.0 yrs vs yrs)
33 Prediabetes Well documented, highly significant reduction of new cases of type 2 diabetes Recently onset type 2 diabetes Well documented high potential for diabetes remission; documented reduction in the incidence of macro- and micro- vascular complications Type 2 diabetes with initial macro- and micro-vascular complications Possible regression of macro- and micro-vascular complication suggested in some study Type 2 diabetes with established end-stage macro- or micro-vascular complications No regression and in some cases progression of micro- vascular complications (diabetic nephropathy and retinopathy); no gain in survival
34 Questions?
The Surgical Management of Obesity
The Surgical Management of Obesity Omar al noubani MD,MRCS وك ل وا و اش ز ب وا و ال ت س رف وا األعراف ما مأل ابن آدم وعاء شر ا من بطنه Persons who are naturally fat are apt to die earlier than those who
More informationA Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications
A Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications Shahzeer Karmali MD FRCSC FACS Associate Professor Surgery University of Alberta
More informationCommonly Performed Bariatric Procedures in Singapore. Lin Jinlin Associate Consultant General, Upper GI and Bariatric Surgery Changi General Hospital
Commonly Performed Bariatric Procedures in Singapore Lin Jinlin Associate Consultant General, Upper GI and Bariatric Surgery Changi General Hospital Scope 1. Introduction 2. Principles of bariatric surgery
More informationLecture Goals. Body Mass Index. Obesity Definitions. Bariatric Surgery What the PCP Needs to Know 11/17/2009. Indications for bariatric Surgeries
Bariatric Surgery What the PCP Needs to Know Mouna Abouamara Assistant Professor Internal Medicine James H Quillen College Of Medicine Lecture Goals Indications for bariatric Surgeries Different types
More informationBARIATRIC SURGERY. Weight Loss Surgery. A variety of surgical procedures to reduce weight performed on people who have obesity. Therapy Male & Female
BARIATRIC SURGERY Weight Loss Surgery A variety of surgical procedures to reduce weight performed on people who have obesity. Therapy Male & Female About Bariatric surgery Bariatric surgery offers a treatment
More informationAdipocytes, Obesity, Bariatric Surgery and its Complications
Adipocytes, Obesity, Bariatric Surgery and its Complications Daniel C. Morris, MD, FACEP, FAHA Senior Staff Physician Department of Emergency Medicine Objectives Basic science of adipocyte Adipocyte tissue
More informationPolicy Specific Section: April 14, 1970 June 28, 2013
Medical Policy Bariatric Surgery Type: Medical Necessity and Investigational / Experimental Policy Specific Section: Surgery Original Policy Date: Effective Date: April 14, 1970 June 28, 2013 Definitions
More informationBariatric Surgery. The Oregon Bariatric Center Surgical Team
Bariatric Surgery The Oregon Bariatric Center Surgical Team Colin MacColl, MD, Medical Director, Bariatric Surgeon Jessica Folek, MD, Bariatric Surgeon I have no disclosures Disclosures Objectives What
More informationADVANCE AT YOUR OWN PACE
ADVANCE AT YOUR OWN PACE Welcome and Introductions Obesity and Its Impact on Health Surgeon Introduction Surgical Weight Loss Options AGENDA OSVALDO ANEZ, MD 28 years of experience Performed approximately
More informationSURGICAL MANAGEMENT OF MORBID OBESITY
Página 1 de 9 Copyright 2001 Lippincott Williams & Wilkins Greenfield, Lazar J., Mulholland, Michael W., Oldham, Keith T., Zelenock, Gerald B., Lillemoe, Keith D. Surgery: Scientific Principles & Practice,
More informationBariatric Surgery: Indications and Ethical Concerns
Bariatric Surgery: Indications and Ethical Concerns Ramzi Alami, M.D. F.A.C.S Assistant Professor of Surgery American University of Beirut Medical Center Beirut, Lebanon Nothing to Disclose Determined
More informationHere are some types of gastric bypass surgery:
Gastric Bypass- Definition By Mayo Clinic staff Weight-loss (bariatric) surgeries change your digestive system, often limiting the amount of food you can eat. These surgeries help you lose weight and can
More informationGastrointestinal Surgery for Severe Obesity 2.0 Contact Hours Presented by: CEU Professor
Gastrointestinal Surgery for Severe Obesity 2.0 Contact Hours Presented by: CEU Professor 7 www.ceuprofessoronline.com Copyright 8 2007 The Magellan Group, LLC All Rights Reserved. Reproduction and distribution
More informationBARIATRIC SURGERY AND OTHER INVASIVE TREATMENTS FOR OBESITY
Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Medical Coverage Guideline must be read in its
More informationProtocol. Bariatric Surgery
Protocol Bariatric Surgery (70147) Medical Benefit Effective Date: 04/01/18 Next Review Date: 11/18 Preauthorization No Review Dates: 04/07, 05/08, 05/09, 03/10, 03/11, 07/11, 07/12, 9/12, 05/13, 01/14,
More informationDemographics IDN: DOB: / / Gender: Male Female. Race: White Black or African American American Indian or Alaska Native
MBSAQIP Case Number: Name: Demographics IDN: LMRN: DOB: / / Gender: Male Female Race: White Black or African American American Indian or Alaska Native Native Hawaiian/Other Pacific Islander Asian Unknown
More informationJAWDA Bariatric Quality Performance Indicators. JAWDA Quarterly Guidelines for Bariatric Surgery (BS)
JAWDA Guidelines for Bariatric Surgery (BS) January 2019 1 Table of Contents Executive Summary... 3 About this Guidance... 4 Bariatric Surgery Indicators... 5 Appendix A: Glossary... 19 Appendix B: Approved
More informationWeight Loss Surgery. Outline 3/30/12. What Every GI Nurse Needs to Know. Define Morbid Obesity & its Medical Consequences. Treatments for Obesity
3/30/12 Weight Loss Surgery What Every GI Nurse Needs to Know Kenneth A Cooper, D.O. March 31, 2012 Outline Define Morbid Obesity & its Medical Consequences Treatments for Obesity Bariatric (Weight-loss)
More informationLaparoscopic Weight Loss Surgery (Bariatric Surgery) A simple guide to help answer your questions
Laparoscopic Weight Loss Surgery (Bariatric Surgery) A simple guide to help answer your questions Weight problems are growing in the US More than 100 million Americans are overweight Half of these people
More informationObjectives. By the end of this educational encounter the learner will be able to:
Complications of Bariatric Surgery WWW.RN.ORG Reviewed September 2017, Expires September 2019 Provider Information and Specifics available on our Website Unauthorized Distribution Prohibited 2017 RN.ORG,
More informationLong Term Follow-up. 6 Month 1 Year Annual enter year #: What is the assessment date: / / Unknown. Is the patient alive? Yes No
Long Term Follow-up 6 Month 1 Year Annual enter year #: What is the assessment date: / / Unknown Is the patient alive? Yes No Was an exam performed by a bariatric physician or PA/NP? Yes No Was the patient
More informationBariatric Surgery Corporate Medical Policy
Bariatric Surgery Corporate Medical Policy File name: Bariatric Surgery File code: UM.SURG.01 Origination: 07/2008 Last Review: 06/2018 Next Review: 06/2019 Effective Date: 10/01/2018 Description/Summary
More informationSee Policy CPT CODE section below for any prior authorization requirements
Effective Date: 9/1/2018 Section: SUR Policy No: 139 Medical Officer 9/1/2018 Date Technology Assessment Committee Approved Date: 3/04; 3/05; 3/06; 4/12; 4/16 Medical Policy Committee Approved Date: 11/08;
More informationWEIGHT LOSS SURGERY A Primer on Current Options and Outcomes. Caitlin A. Halbert DO, MS, FACS, FASMBS April 5, 2018
WEIGHT LOSS SURGERY A Primer on Current Options and Outcomes Caitlin A. Halbert DO, MS, FACS, FASMBS April 5, 2018 A Little Bit About Me Bariatric Surgical Services Reflux Surgery General Surgery Overview
More informationConsidering Bariatric Surgery? Learn about minimally invasive da Vinci Surgery
Considering Bariatric Surgery? Learn about minimally invasive da Vinci Surgery The Surgery: Bariatric Surgery There are many non-surgical treatments for obesity such as dieting, exercise, and medicine.
More informationSURGICAL MANAGEMENT OF OBESITY. Anne Lidor, MD, MPH Professor of Surgery Chief, Division of Minimally Invasive and Bariatric Surgery
SURGICAL MANAGEMENT OF OBESITY Anne Lidor, MD, MPH Professor of Surgery Chief, Division of Minimally Invasive and Bariatric Surgery Multi-Factorial Causes of Morbid Obesity include: Genetic Environmental
More informationBariatric Surgery. Policy Number: Last Review: 12/2018 Origination: 10/1988 Next Review: 12/2019
Bariatric Surgery Policy Number: 7.01.47 Last Review: 12/2018 Origination: 10/1988 Next Review: 12/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for bariatric surgery
More informationMedical Policy. MP Bariatric Surgery. BCBSA Ref. Policy: Last Review: 02/26/2018 Effective Date: 02/26/2018 Section: Surgery
Medical Policy MP 7.01.47 BCBSA Ref. Policy: 7.01.47 Last Review: 02/26/2018 Effective Date: 02/26/2018 Section: Surgery Related Policies 2.01.38 Transesophageal Endoscopic Therapies for Gastroesophageal
More informationSleeve Gastrectomy Debate: Everyone Needs a Sleeve!!! Dana Portenier, MD Assistant Professor of Surgery Duke University Medical Center
Sleeve Gastrectomy Debate: Everyone Needs a Sleeve!!! Dana Portenier, MD Assistant Professor of Surgery Duke University Medical Center 1. Safety Two Year Excess Weight Loss Two Year Weight Loss and Mortality
More informationOverview. Stanley J. Rogers, MD, FACS Associate Clinical Professor of Surgery University of California San Francisco
GASTROINTESTINAL COMPLICATIONS AFTER BARIATRIC SURGERY Stanley J. Rogers, MD, FACS Associate Clinical Professor of Surgery University of California San Francisco UCSF DEPARTMENT OF SURGERY Original Article
More informationINFORMED CONSENT FOR LAPAROSCOPIC ADJUSTABLE GASTRIC BAND. Please read this form carefully and ask about anything you may not understand.
Please read this form carefully and ask about anything you may not understand. I consent to undergo laparoscopic placement of a laparoscopic Adjustable Gastric Band for the purposes of weight loss. I met
More informationImaging findings in complications of bariatric surgery.
Imaging findings in complications of bariatric surgery. Poster No.: C-1791 Congress: ECR 2012 Type: Educational Exhibit Authors: A. Fernandez Alfonso, G. Anguita Martinez, D. C. Olivares Morello, C. García
More information7th International Congress of the Spanish Society of Obesity Surgery. Valladolid Spain May, 2004.
7th International Congress of the Spanish Society of Obesity Surgery. Valladolid Spain May, 2004. DIMINISHING POSTOPERATIVE RISKS OF GASTRIC BYPASS Stenosis Stenosis Leak Leak Bleeding Bleeding Stenosis
More informationMedicare Part C Medical Coverage Policy
Morbid Obesity Surgery Origination: June 30, 1988 Review Date: October 18, 2017 Next Review: October, 2019 Medicare Part C Medical Coverage Policy DESCRIPTION OF PROCEDURE OR SERVICE Bariatric surgery
More informationANZMOSS 2018 Melbourne Bariatric Surgery Masterclass
ANZMOSS 2018 Melbourne Bariatric Surgery Masterclass WHICH OPERATION TO CHOOSE ANTHONY CLOUGH The options SURGICAL OPTIONS? - A MINEFIELD An explosion of operative variants Local technical variations Local
More informationObesity and Bariatric Surgery
Obesity and Bariatric Surgery Disclosure Nothing to disclose Subhashini Ayloo MD, MPH, FACS Associate Professor of Surgery Director of MIS HPB/LT Rutgers, New Jersey Medical School March 24 th, 2017 Overview
More informationMETABOLIC COMPLICATIONS OF BARIATRIC SURGERY. Aleksandr Shteynberg Downstate Medical Center July 7, 2006
METABOLIC COMPLICATIONS OF BARIATRIC SURGERY Aleksandr Shteynberg Downstate Medical Center July 7, 2006 Case presentation 55 year old female was transferred to Downstate Medical Center on March 31, 2006
More informationGoals 1/9/2018. Obesity over the last decade Surgery has become a safer management strategy Surgical options for management
The Current State of Surgical Intervention in Management of Morbid Obesity Goals Obesity over the last decade Surgery has become a safer management strategy Surgical options for management 1 Goals Obesity
More informationChapter 4 Section 13.2
TRICARE Policy Manual 6010.60-M, April 1, 2015 Surgery Chapter 4 Section 13.2 Issue Date: November 9, 1982 Authority: 32 CFR 199.2(b) and 32 CFR 199.4(e)(15) Copyright: CPT only 2006 American Medical Association
More informationThe case for reductive surgery: a more efficient and cost-effective option
Emil Loots MBChB (Pret), FCS (SA) Cert Gastro (SA) Surg PhD Candidate The case for reductive surgery: a more efficient and cost-effective option Big day in Pretoria Controversies Controversy around the
More informationBariatric Surgery: Patient Selection, Complications, What the Internist Should Know
Bariatric Surgery: Patient Selection, Complications, What the Internist Should Know Valerie J. Halpin Legacy Weight and Diabetes Institute November 3, 2017 Surgical Overview Indications Contraindications
More informationSurgical Therapy for Morbid Obesity. Janeen Jordan, PGY 5 Surgical Grand Rounds April 7, 2008
Surgical Therapy for Morbid Obesity Janeen Jordan, PGY 5 Surgical Grand Rounds April 7, 28 Obesity BMI > 3 kg/m 2 Moderate 35-4 kg/m 2 Morbid >4 kg/m 2 1.7 BILLION Overweight Adults in the world 63 MILLION
More informationOBESITY MANAGEMENT: DIET/EXERCISE, NEW DRUGS AND/OR SURGERY?
OBESITY MANAGEMENT: DIET/EXERCISE, NEW DRUGS AND/OR SURGERY? ERIC VOLCKMANN, MD DIRECTOR OF BARIATRIC SURGERY OCTOBER 20, 2017 OBJECTIVES Define prevalence and health effects of obesity Discuss different
More informationForm 1: Demographics
Form 1: Demographics Case Number: *LMRN: *DOB: / / *Gender: Male Female *Race: White Native Hawaiian/Other Pacific Islander Black or African American Asian American Indian or Alaska Native Unknown *Hispanic
More informationDemographics. MBSAQIP Case Number: *ACS NSQIP Case Number: *LMRN: *DOB: / / *Gender: Male Female
Demographics MBSAQIP Case Number: *IDN: *ACS NSQIP Case Number: Name: *LMRN: *DOB: / / *Gender: Male Female *Race: White Black or African American American Indian or Alaska Native Native Hawaiian/Other
More informationChapter 4 Section 13.2
Surgery Chapter 4 Section 13.2 Issue Date: November 9, 1982 Authority: 32 CFR 199.2(b) and 32 CFR 199.4(e)(15) 1.0 CPT 1 PROCEDURE CODES 43644, 43770-43774, 43842, 43846, 43848 2.0 HCPCS PROCEDURE CODES
More informationCorporate Medical Policy. Bariatric (Surgery for Morbid Obesity)
Corporate Medical Policy Bariatric (Surgery for Morbid Obesity) File name: Bariatric (Obesity Surgery) Origination: 07/2008 Last Review: 07/2009 Next Review: 07/2010 Effective Date: 12/08/2008 Description
More informationChoice Critria in Bariatric Surgery. Giovanni Camerini
Choice Critria in Bariatric Surgery Giovanni Camerini Surgical vs Medical treatment Indications for Bariatric Surgery (WHO 1992) BMI of at least 40; BMI of 35 in case of serious diseases related to obesity;
More informationINFORMED CONSENT FOR LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS SURGICAL PROCEDURE
INFORMED CONSENT FOR LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS SURGICAL PROCEDURE It is very important to Venice Metabolic and Bariatric Surgery that you understand and consent to the treatment your doctor
More informationOBESITY/OVERWEIGHT. Fastest spreading disaster of the century- Bariatric Surgical treatment. By Dr. Vladimir Shchukin Consultant General Surgeon
OBESITY/OVERWEIGHT Fastest spreading disaster of the century- Bariatric Surgical treatment By Dr. Vladimir Shchukin Consultant General Surgeon Indications for surgical treatment Indication for Gastric
More informationBariatric Surgery: The Primary Care Approach
The 8 th Annual Conference of the Lebanese Society of Family Medicine October 25 th 2009 Bariatric Surgery: The Primary Care Approach Bassem Y. Safadi, MD, FACS Associate Professor of Clinical Surgery
More informationMedical Coverage Policy Bariatric Surgery EFFECTIVE DATE: POLICY LAST UPDATED:
Medical Coverage Policy Bariatric Surgery EFFECTIVE DATE: 11 04 2014 POLICY LAST UPDATED: 07 17 2018 OVERVIEW Surgery for obesity, termed bariatric surgery, is a treatment for morbid obesity in patients
More informationClinical Quality Measures for PQRS. Last Updated: June 4, 2014
Clinical Quality Measures for PQRS Last Updated: June 4, 2014 The Michigan Bariatric Surgery Collaborative (MBSC) Quality Clinical Data Registry will submit the following measures outlined below on behalf
More informationImaging features of the complications of bariatric surgery
Imaging features of the complications of bariatric surgery Poster No.: C-2173 Congress: ECR 2014 Type: Authors: Educational Exhibit M. Lahkim 1, J. Lucas 2, A. HAMEG 3, P. Lacombe 4 ; 1 Rabat/MA, 2 Neuilly/Seine/FR,
More informationMBSAQIP Complex Clinical Scenarios & Variable Review
MBSAQIP Complex Clinical Scenarios & Variable Review Disclosure The following planners, speakers, moderators, and/or panelists of the CME/CEU activity have no relevant financial relationships with commercial
More informationInternational Health Brief
International Health Brief Bariatric Surgery In this Health Brief, we look at the growing utilization of bariatric surgery as a means of achieving rapid weight loss, and consider if it should be covered
More informationAssociate. Professor of. Minimally. Invasive Surgery
Surgical Task Force Recommendations Ken Reed MD, FRSCS Committee Chair, and Staff Surgeon, Guelph General Hospital Clinical Associate Professor of Surgery, McMaster University Dennis Hong MD, MS.c, FRCSC,
More informationBariatric Surgery. Overview of Procedural Options
Bariatric Surgery Overview of Procedural Options The Obesity Epidemic In 1991, NO state had an obesity rate above 20% 1 As of 2010, more than two-thirds of states (38) now have adult obesity rates above
More informationBariatric Nursing Review Course Session II. Choice of Procedures and Preoperative Care
Bariatric Nursing Review Course Session II Choice of Procedures and Preoperative Care Purpose/Objectives The purpose of this program is to educate nurses about the bariatric choice of procedures and preoperative
More informationMetabolic & Bariatric Surgery Program Information Session
Metabolic & Bariatric Surgery Program Information Session Why have Bariatric Surgery at MUSC? The Expert Experience Most established program in the area Dedicated interdisciplinary team Recognized and
More informationOriginal Policy Date
MP 7.01.35 Bariatric Surgery Medical Policy Section Surgery Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013 Return to Medical Policy Index Disclaimer
More information3 Things To Know About Obesity Surgery
3 Things To Know About Obesity Surgery Dr Jon Armstrong 1st Edition Introduction... 3 1. Am I A Candidate?... 4 2. What Are The Options?... 5 3. How Does It Work?... 6 Conclusion... 9 Follow me here...
More informationClinical application of laparoscopic bariatric surgery
Clinical application of laparoscopic bariatric surgery A steady rise in obesity prevalence over the last 20 years has been experienced by whole world. This trend is ominous, because morbid obesity predisposes
More informationMustafa W. Aman, M.D. Director, Bariatric Surgery Program Guthrie Robert Packer Hospital
09/16/2017 presented by: Mustafa W. Aman, M.D. Director, Bariatric Surgery Program Guthrie Robert Packer Hospital I have no financial disclosures pertaining to any commercial interests Describe the role
More informationERCP in altered anatomy. Lars Aabakken Oslo University Hospital - Rikshospitalet Oslo, Norway
ERCP in altered anatomy Lars Aabakken Oslo University Hospital - Rikshospitalet Oslo, Norway CO2 as insufflation gas Reduces post-procedure pain Reduces in-procedure bowel distension Improves the intubation
More informationLaparoscopic Gastric Bypass Information
1441 Constitution Boulevard, Salinas, CA 93906 (831) 783-2556 www.natividad.com/weight-loss (Roux-en-Y Gastric Bypass) What is gastric bypass surgery? Gastric bypass surgery, a type of bariatric surgery
More informationRemoval of a lap band and revision to an alternative bariatric procedure in one procedure.
How to Discuss the Case with Insurance Plan Medical Director, Letter of Medical Necessity, and Increasing the Chance of Letters of Medical Necessity are a well-known requirement when requesting authorization
More information2. Overview of Bariatric Operations
2. Overview of Bariatric Operations Daniel E. Swartz and Edward L. Felix A. Overview of Bariatric Surgery Overweight, obesity, and morbid obesity, defined as body mass indices greater than or equal to
More informationNOTE: This policy is not effective until May 1, To view the current policy, click here. IMPORTANT REMINDER
NOTE: This policy is not effective until May 1, 2018. To view the current policy, click here. Medical Policy Manual Surgery, Policy No. 58 Bariatric Surgery Next Review: December 2018 Last Review: January
More informationBariatric surgery. KHALAJ A.R. M.D Obesity Clinic Mostafa Khomini Hospital Shahed University Tehran
Bariatric surgery KHALAJ A.R. M.D Obesity Clinic Mostafa Khomini Hospital Shahed University Tehran WWW.IRANOBESITY.COM Why Surgery? What is Indication of Surgery? What is ContraIndication of surgery? What
More informationGastric bypass vs. Sleeve gastrectomy
Gastric bypass vs. Sleeve gastrectomy SLEEVEPASS-study Sleeve gastrectomy Paulina Salminen, M.D., PhD Turku University Hospital Department of Surgery Stockholms Obesitasdagar 19.4.2012 Swedish Obese Subjects
More informationAppendix 1. List of diagnostic, intervention, and medical service billing codes used to select individuals in the three groups.
Appendix 1. List of diagnostic, intervention, and medical service billing codes used to select individuals in the three groups. Obesity ICD-9-CM diagnostic codes 278.0 and 278.9 ICD-10-CA diagnostic codes
More informationNot over when the surgery is done: surgical complications of obesity
Not over when the surgery is done: surgical complications of obesity Gianluca Bonanomi, MD, FRCS Consultant Surgeon and Honorary Senior Lecturer Chelsea and Westminster Hospital London The Society for
More informationViriato Fiallo, MD Ursula McMillian, MD
Viriato Fiallo, MD Ursula McMillian, MD Objectives Define obesity and effects on society and healthcare Define bariatric surgery Discuss recent medical management versus surgery research Evaluate different
More informationComplications after laparoscopic gastric bypass for morbid obesity. Background LGBP. Eirik Hornes Halvorsen, MD, PhD Oslo
Complications after laparoscopic gastric bypass for morbid obesity Eirik Hornes Halvorsen, MD, PhD Oslo 20.05.2015 Background Ca 3000 patients are surgically treated for morbid obesity in Norway each year.
More informationIndex. B Balloon dilations, 140, 144 Bariatric emergencies cardiac complications, cardiovascular system, 42 gastric band placement, 42
A Acceptance and Commitment Therapy (ACT), 157 158 Acceptance-Based Behavioral Treatment (ABBT), 157 Adjustable gastric bands (AGB), 8, 115 Air-leak test, 80 American Association of Clinical Endocrinologist
More informationObesity Management Workshop for Health Professionals
Obesity Management Workshop for Health Professionals 17 th November 2017 Dr Graeme Rich Gastroenterologist Director of Bariatrics Australia Is a procedure the magic bullet? Energy in >> Energy out Accepted
More informationBARIATRIC SURGERY. Status Active. Medical and Behavioral Health Policy Section: Surgery Policy Number: IV-19 Effective Date: 10/20/2014.
Status Active Medical and Behavioral Health Policy Section: Surgery Policy Number: IV-19 Effective Date: 10/20/2014 Blue Cross and Blue Shield of Minnesota medical policies do not imply that members should
More informationBariatric Surgery. Policy Number: Last Review: 3/2014 Origination: 10/1988 Next Review: 12/2014
Bariatric Surgery Policy Number: 7.01.47 Last Review: 3/2014 Origination: 10/1988 Next Review: 12/2014 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for bariatric surgery
More informationBariatric Surgery. Options & Outcomes
Bariatric Surgery Options & Outcomes Obesity Obesity now leading cause of premature death & illness in Australia 67% of Australians are overweight or obese Australia 4 th fattest nation in OECD Obesity
More informationLaparoscopic conversion of Gastric Banding into Roux-en-Y gastric bypass
Laparoscopic conversion of Gastric Banding into Roux-en-Y gastric bypass Dr. Tawfik Abuzalout Dr. Antonio iannelli Prof. Jean Gugenheim Departement of digestive surgery and liver transplantation, Archet2
More informationBenefits of Bariatric Surgery
Benefits of Bariatric Surgery Dr Tan Bo Chuan Registrar, Department of Surgery GP Forum 27 May 2017 Improvements of Co-morbidities Type 2 diabetes mellitus Hypertension Hyperlipidemia Degenerative joint
More informationRestrictive Procedures: Band and Sleeve
Restrictive Procedures: Band and Sleeve Jin S. Yoo M.D. Assistant Professor of Surgery Jin.Yoo@duke.edu Disclosures Speaker for Cook Medical, Covidien, W.L. Gore Consultant for Musculoskeletal Transplant
More informationLong-Term Follow Up: The Burning Platform
Long-Term Follow Up: The Burning Platform John Morton, MD, MPH, FACS, FASMBS Chief, Bariatric & Minimally Invasive Surgery Stanford School of Medicine Past-President, American Society of Metabolic and
More informationACS-NSQIP 2015 Julietta Chang MD, Ali Aminian MD, Stacy A Brethauer MD, Philip R Schauer MD Bariatric and Metabolic Institute
ACS-NSQIP 2015 Julietta Chang MD, Ali Aminian MD, Stacy A Brethauer MD, Philip R Schauer MD Bariatric and Metabolic Institute Disclosures Authors: No disclosures ACS-NSQIP Disclaimer: The American College
More informationJordan Garrison Jr. MD, FACS, FASMBS
Jordan Garrison Jr. MD, FACS, FASMBS A life-long progressive, lifethreatening, geneticallyrelated, costly, multifactorial disease of excess fat storage with multiple comorbidities ~ 25% industrialized
More informationThe Bariatric and Heartburn Center of Northeast Ohio
The Bariatric and Heartburn Center of Northeast Ohio A message from Dr. Chlysta: Walter J. Chlysta MD, FACS, FASMBS 1900 23 rd Street, Suite 403 Cuyahoga Falls, OH 44223 Phone 330-926-3443 Fax 330-255-5092
More informationPostgastrectomy Syndromes
Postgastrectomy Syndromes Postgastrectomy syndromes are iatrogenic conditions that may arise from partial gastrectomies, independent of whether the gastric surgery was initially performed for peptic ulcer
More informationBariatric Surgery for Weight Loss
#60982 Bariatric Surgery for Weight Loss COURSE #60982 5 CE CREDITS Release Date: 06/01/18 Expiration Date: 05/31/21 Bariatric Surgery for Weight Loss Faculty John J. Whyte, MD, MPH, is currently the Director
More informationTechnique. Matthew Bettendorf, MD Essentia Health Duluth Clinic. Laparoscopic approach One 12mm port, Four 5mm ports
Matthew Bettendorf, MD Essentia Health Duluth Clinic Technique Laparoscopic approach One 12mm port, Four 5mm ports Single staple line with no anastamosis 85% gastrectomy Goal to remove
More informationBariatric Surgery MM /11/2001. HMO; PPO; QUEST 05/01/2012 Section: Surgery Place(s) of Service: Outpatient; Inpatient
Bariatric Surgery Policy Number: Original Effective Date: MM.06.003 09/11/2001 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST 05/01/2012 Section: Surgery Place(s) of Service: Outpatient;
More informationDisclosures. Weight Regain After Bariatric Surgery & Future Therapies. Objectives
Weight Regain After Bariatric Surgery & Future Therapies Matthew Kroh, MD Assistant Professor of Surgery Cleveland Clinic Center for Surgical Innovation, Technology, and Education Digestive Disease Institute
More informationIs laparoscopic sleeve gastrectomy safer than laparoscopic gastric bypass?
Is laparoscopic sleeve gastrectomy safer than laparoscopic gastric bypass? A comparison of 30-day complications using the MBSAQIP data registry Sandhya B. Kumar MD, Barbara C. Hamilton MD, Soren Jonzzon,
More informationMarc Bessler, M.D.*, Amna Daud, M.D., M.P.H., Teresa Kim, M.D., Mary DiGiorgi, M.P.H.
Surgery for Obesity and Related Diseases 3 (2007) 480 485 Original article Prospective randomized trial of banded versus nonbanded gastric bypass for the super obese: early results Marc Bessler, M.D.*,
More informationBariatric Surgery Outcomes
Bariatric Surgery Outcomes Kristoffel R. Dumon, MD a, Kenric M. Murayama, MD b, * KEYWORDS Bariatric surgery Outcomes Obesity Obesity is a global health problem and the exponential increase in obesity
More informationPolicy and Procedure. Department: Utilization Management. SNP, CHP, MetroPlus Gold, Goldcare I&II, Market Plus, Essential, HARP
Retired Date: Page 1 of 12 1. POLICY DESCRIPTION: Bariatric Surgery 2. RESPONSIBLE PARTIES: Medical Management Administration, Utilization Management, Integrated Care Management, Pharmacy, Claim Department,
More informationBariatric surgery: has anything changed in the last few years?
Bariatric surgery: has anything changed in the last few years? Mauro Toppino University of Turin Digestive and Colorectal Surgery Minimal Invasive Surgery Center (Head:Prof. Mario Morino) XIV Annual Conference
More informationThe essential bariatric surgery primer: what all radiologists need to know
The essential bariatric surgery primer: what all radiologists need to know Poster No.: C-2371 Congress: ECR 2013 Type: Educational Exhibit Authors: H. Lambie, K. Harris, J. BRITTENDEN, D. Tolan ; Leeds/UK,
More informationEndoscopic Interventions
Endoscopic Interventions Shelby Sullivan, MD Director of the Gastroenterology Metabolic and Bariatric Program University of Colorado School of Medicine Disclosures Shelby Sullivan, M.D. has financial interests
More information